A Multicentre Clinical Investigation of a Decision Support Algorithm for Neonatal Seizure Detection

Not Applicable

Completed

• Conditions: Neurologic Manifestations; Seizures; Epilepsy; Brain Diseases; Nervous System Diseases; Central Nervous System Diseases
• Interventions: Device: ANSeR Software System

• Registration Number: NCT02431780
• Lead Sponsor: University College Cork

Brief Summary

The ANSeR Clinical Investigation is a multi-centre, randomised, controlled, clinical investigation of a standalone decision support Algorithm for Neonatal Seizure Recognition, the ANSER Software system.

Detailed Description

This will be an open, two arm, parallel group, randomised, controlled investigation of the ANSeR Software System as a stand-alone neonatal seizure recognition decision support tool. Term neonates requiring EEG monitoring will be stratified by recruiting site and then randomised to receive either EEG monitoring with the ANSeR Software System or EEG monitoring without the ANSeR Software System.

It is proposed that the rate of true detections (sensitivity) of investigation personnel using the ANSeR Software System in clinical practice will be at least 25% higher than that of investigation personnel not using the ANSeR Software System in routine clinical practice. In addition we expect the specificity of investigation personnel using the ANSeR Software System to be no worse than 10% less than that of investigation personnel not using the ANSeR Software System. This should result in more appropriate and timely use of antiepileptic drugs (AED).

Randomisation Immediately following enrolment in the investigation, each participant will be randomly assigned to receive either EEG monitoring with the ANSeR Software System or without the ANSeR Software System. Randomisation will be stratified by recruiting site with a 1:1 allocation ratio to each group. Block randomisation with varying block sizes will be used and the randomisation and allocation will be performed centrally using a web-based electronic system.

Blinding As this is an investigation of a medical device (software), the investigation personnel will be aware of which group the participant is assigned to. The expert panel who are the diagnostic reference standard will be blinded to group allocation. The biostatistician will also be blinded to group allocation during the analysis of the data.

Study Timeline

• Study First Submitted: 2014-11-14
• Study Start: 2015-02-12
• Study First Submitted QC: 2015-04-30
• Study First Posted: 2015-05-01
• Primary Completion: 2017-02-07
• Study Completion: 2017-02-07
• Status Verified: 2023-12
• Last Update Submitted: 2023-12-04
• Last Update Posted: 2023-12-11

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 264

Inclusion Criteria

• Neonates 36 weeks - 44 weeks corrected gestational age in whom EEG monitoring is indicated because they are deemed to be

  • at high risk of seizures or
  • are experiencing seizures

Exclusion Criteria

• • No parental/guardian consent

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
ANSeR Software System	ANSeR Software System	The intended use of the ANSeR Software System is to provide a real time decision support tool to assist in the diagnosis of seizures in neonates (between 36 weeks and 44 weeks corrected age) and to provide a review tool for EEG and seizure analysis. ANSeR is intended to provide a reliable, effective, objective and intuitive means of identifying seizures

Primary Outcome Measures

Name	Time	Method
The Seizure Detection Rate for all Neonates enrolled in the investigation arm compared to Seizure Detection Rate for all Neonates in the control arm.	12-18 months	The rate of true seizure detection (sensitivity), as recorded on a Seizure Record form, 25% superior in the investigation arm compared to the control group (usual clinical practice). The Expert Committee will be used as the diagnostic reference standard.
The False Detections per hour (sensitivity) for all Neonates enrolled in the investigation arm compared to the False Detection Rate for all Neonates in the control arm.	12-18 months	The False Detections per hour (specificity), as recorded on a Seizure Record form, 10% superior in the investigation arm compared to the control group (usual clinical practice). The Expert Committee will be used as the diagnostic reference standard.

Secondary Outcome Measures

Name	Time	Method
Seizure burden (min) for all Neonates enrolled in the investigation arm compared to Seizure burden (min) for all Neonates in the control arm.	12-18 months	To quantify seizure burden (min) in the investigation arm and control arm.
Number of Neonates administered Anti-epileptic drug (AED) in the investigation arm compared to Number of Neonates administered Anti-epileptic drug (AED) in the control arm.	12-18 months

Trial Locations

Locations (8)

University Medical Centre Utrecht, Wilhelmina Children's Hospital; 🇳🇱 Utrecht, Netherlands

Cork University Maternity Hospital; 🇮🇪 Wilton, Cork, Ireland

Rotunda Maternity Hospital; 🇮🇪 Dublin, Ireland

University College London Hospitals NHS Foundation Trust; 🇬🇧 London, United Kingdom

Karolinska Institutet and University Hospital; 🇸🇪 Huddinge, Stockholm, Sweden

The London and Homerton Hospital; 🇬🇧 London, United Kingdom

Barts and the London NHS Trust,; 🇬🇧 London, United Kingdom

Great Ormond Street Hospital; 🇬🇧 London, United Kingdom